目前主要的国内外指南均推荐二甲双胍(metformin)作为治疗2型糖尿病起始、基础和全程的一线治疗药物.随着二甲双胍的广泛临床应用,其在保护心血管作用、改善血脂代谢、非酒精性脂肪性肝病、肥胖、治疗多囊卵巢综合征、抗肿瘤作用等多个领域的应用价值也不断被发现.近年来二甲双胍与甲状腺肿瘤之间的研究亦较为火热,有研究[1]表明,二甲双胍在降低促甲状腺激素(TSH)水平的同时减小甲状腺良性结节的体积,能够拮抗胰岛素的促增殖效应,并且增强化疗药物敏感性,具有抗肿瘤细胞及肿瘤干细胞增殖生长的作用.关于二甲双胍与甲状腺癌的研究进展进行综述如下.

Single-nucleotide polymorphism (SNP) haplotype and SNP-SNP interactions of CTLA-4 and CD40 genes, with susceptibility to Graves’ disease (GD), were explored in a Chinese Han population.

目的 观察二甲双胍单药、罗格列酮或联合应用对乳腺癌MCF-7细胞周期和凋亡的影响.方法 用浓度为20 mmol/L二甲双胍(二甲双胍组)、100 μmol/L罗格列酮(罗格列酮)及二甲双胍联合罗格列酮(联合用药组)处理MCF-7细胞48h,分别采用MTT法、流式细胞术、Hoechst33258染色法观察细胞增殖、周期、凋亡情况.结果 二甲双胍组、联合用药组的MCF-7细胞增殖被显著抑制,二甲双胍组、罗格列酮组、联合用药组阻滞MCF-7细胞于G0/G1期比例增加,S、G2/M期比例减少,二甲双胍组、罗格列酮组、联合用药组的细胞早期凋亡率分别为(15.3±1.09)％、(12.4±1.73)％、(17.2±1.63)％,与对照组比较差异有统计学意义(P＜0.01).结论 单用二甲双胍或联合罗格列酮均能抑制MCF-7细胞的增殖,诱导其细胞周期停滞和凋亡.

目的 了解粤北少数民族地区留守居民生存质量现状,探讨家庭功能与生存质量和抑郁的相关性.方法 2015年7～8月对广东省连南县少数民族地区314名留守居民,采用家庭功能评定量表(APGAR)、抑郁自评量表(SDS)和世界卫生组织生存质量测定量表(WHOQOL-BREF)进行问卷调查.结果 314名少数民族地区留守居民生存质量4个领域得分分别为生理领域(62.01±12.76)分,心理领域(60.44±12.13)分、社会关系领域(64.12±14.52)分、环境领域(53.84±13.63)分,综合健康状况自我评分为(78.81±12.55)分,家庭功能良好占65.92％(207/314),抑郁发生率18.48％(58/314),家庭功能与抑郁存在相关性(r=-0.155,P＜0.01);生理、心理领域生存质量得分已婚居民低于其他居民(P ＜0.05),农业劳动者低于非农业劳动者(P＜0.05),做生意居民低于其他收入来源居民但高于种田居民(P＜0.05),环境领域生存质量得分高收入居民高于低收入居民;年龄越大生存质量评分越低(P＜0.05).结论 粤北少数民族地区留守居民生存质量受到年龄、婚姻、职业和收入的影响,家庭功能与抑郁存在相关,良好的家庭功能可以减低抑郁的发生率,应重视家庭功能对留守居民心理健康的影响.

The aim of this study was to investigate whether a genetic combined effect exists between CD40-1C>T and CTLA-4+6230G>A (CT60) polymorphisms and whether the combined effect renders susceptibility to Graves' disease (GD). We recruited 260 patients with GD and 248 healthy controls. Single nucleotide polymorphisms were genotyped by polymerase chain reaction-high resolution melting. Genetic polymorphisms related to GD were identified, levels of thyroid stimulating hormone receptor antibodies (TRAb) were measured, and genetic interactions were assessed by logistic regression analysis. Significant difference in allele and genotype frequency of CD40-1C>T polymorphism was observed between the patients and control subjects (P<0.001, 0.002 respectively). As for CTLA-4+6230G>A polymorphism, significant difference was observed only in allele frequencies between the patient and control groups (P=0.014). Moreover, a significant combined effect was presented in CD40-1C>T and CTLA-4+6230G>A polymorphism (P=0.020), and all, but one, combination CC-genotype of CD40-1C>T and GG-genotype of CTLA-4+6230G>A polymorphism has 54% lower risk of GD development than subjects with the CC and GG genotypes (OR=0.46, 95% CI=0.25-0.84). In newly onset GD group, neither single SNP (CD40-1C>T or CTLA-4+6230G>A polymorphism) nor their combined effect was showed a significant association with TRAb concentration (all P>0.05). Our findings suggest a possible additive combined effect between CD40-1C>T and CTLA4+6230G>A polymorphisms in the development of GD.